O presente trabalho consiste em uma análise das práticas educacionais desenvolvidas e voltadas para crianças e adolescentes em situação de abrigo ao longo da história nacional. Atualmente denominada como acolhimento institucional, esta prática é garantida pela Lei 8069/90 como uma medida de proteção e suas unidades de atendimento social são entendidas como espaços socioeducativos. A investigação empírica realizada em três instituições distintas durante a pesquisa apresenta evidências de que seu caráter educativo ainda está distante do ideal de desenvolvimento integral preconizado pela Lei, prevalecendo práticas pautadas no desrespeito à subjetividade daqueles que deveriam ser a razão de sua existência. Assim, este trabalho busca fazer um resgate histórico destas práticas, seguido pela apresentação da realidade atual constatada por meio da observação-participante, para uma posterior reflexão e proposição de um trabalho socioeducativo que seja realmente significativo para os acolhidos institucionalmente nestes espaços. / This study is an analysis of educational practices and programs for children and adolescents in a shelter along the national history. Currently known as shelter, this practice is guaranteed by Law 8069/90 as a measure of protection and their social service units are understood as socio-educational spaces. Empirical research carried out in three different institutions during the study presents evidence that its educational nature is still far from the ideal of integral development envisaged by the law, prevailing practices based on disrespect to the subjectivity of those who should be the reason for their existence. This study seeks to make a historical review of these practices, followed by the presentation of the current reality observed through participant observation, for further discussion and proposal of a social-educational work that is really significant for the institutionally accepted in these spaces.

Introdução: os transtornos mentais freqüentemente têm início na infância e podem persistir até a idade adulta. Assim, transtornos mentais em crianças e adolescentes apresentam alta prevalência. Determinantes ambientais, genéticos, biológicos e comportamentais têm sido investigados na etiologia dos transtornos mentais. Objetivos: estudar a prevalência e a continuidade dos transtornos mentais no início da adolescência e os determinantes precoces para problemas de atenção e hiperatividade na mesma faixa etária. Métodos: realizaram-se dois estudos com delineamento prospectivo de coorte e um estudo transversal aninhado ao estudo longitudinal com duas fases: triagem e diagnóstico de saúde mental. Em 1993, todos os nascimentos hospitalares ocorridos na cidade de Pelotas foram monitorados (N = 5.249). Amostras destas crianças foram visitadas no primeiro e no quarto ano de vida. Em 2004-5, 4.452 (87,5% da coorte original) adolescentes e suas mães foram entrevistados. Neste seguimento, foram utilizados três instrumentos de coleta de dados sobre saúde mental. Inicialmente, 4.452 adolescentes e suas mães responderam ao Questionário de Capacidades e Dificuldades (SDQ) para avaliar problemas de saúde mental dos adolescentes. Os adolescentes com rastreamento positivo (na versão do SDQ das mães ou na de auto-preenchimento), mais uma amostra com rastreamento negativo, foram selecionados (juntamente com suas mães) para responderem à entrevista Levantamento sobre o Desenvolvimento e Bem-estar de Crianças e Adolescentes (DAWBA). Procedeu-se a uma nova visita domiciliar para uma entrevista com as mães de uma amostra de adolescentes (os mesmos avaliados aos 4 anos), utilizando o Inventário de Comportamentos da Infância e Adolescência (CBCL). Resultados: a prevalência de transtornos mentais no início da adolescência foi estimada em 10,8% (IC 95% 5,7-15,9%), sendo os grupos de transtornos mais prevalentes os do comportamento disruptivo, seguidos dos de ansiedade. Na reaplicação do CBCL após oito anos (aos 4 e 12 anos de idade), houve uma continuidade moderada da psicopatologia. Assim 31% das crianças com comportamento desviante aos 4 anos persistiam com esses comportamentos aos 12 anos. Os problemas de externalização aos 4 anos foram os que apresentaram maior estabilidade em 8 anos e, também, os principais preditores de diferentes desfechos em saúde mental. Os fatores de risco (coletados no nascimento e quarto ano) que permaneceram associados aos problemas de atenção e hiperatividade aos 12 anos foram: a) renda familiar; b) sexo masculino; c) tabagismo materno na gestação; d) transtorno psiquiátrico materno; e) problemas de comportamento e emocionais da criança. Conclusões: os resultados mostraram-se similares aos achados de estudos, brasileiros e internacionais, em relação às taxas de prevalências, aos padrões de psicopatologia mais freqüentes, à evolução, aos antecedentes comportamentais e aos fatores de risco dos transtornos mentais, apontando para a universalidade dos transtornos mentais entre diferentes culturas. Fatores ambientais, biológicos e psicológicos, presentes no início da vida, tiveram efeito de longo prazo em escores de desatenção e hiperatividade na adolescência, confirmando achados prévios de estudos de coortes de nascimentos. / Introduction: mental disorders often begin during childhood and may persist up to the adult age. In addition, their prevalence in children and adolescent is high. Environmental, genetics, biological and psychological determinants have been investigated in the etiology of mental disorder. Objectives: to study the prevalence and the continuity of mental disorders in the early adolescence, as well as early determinants for attention and hyperactivity problems at the same age range. Methods: two studies with a cohort prospective design were developed and a transversal study was nested into the longitudinal study with two phases: screening and diagnoses of mental disorder. In 1993, all the births which took place in hospitals in the city of Pelotas were monitored (N = 5,249). Samples of these children were visited in the first and fourth year of age. In 2004-5, 4,452 (87.5% of the original cohort) adolescents and their mothers were interviewed. In this follow-up, three instruments assessing the mental health of the adolescents were applied. Initially, 4,452 adolescents and their mothers answered to the Strenghs and Difficulties Questionnaire (SDQ) to evaluate problems of mental health of the adolescents. The adolescents with positive screening (in the SDQ of the mothers or self-report versions), and a sample of those with negative screening, were selected (as well as their mothers) to answer to the Development and Well-Being of Children and Adolescents Interview (DAWBA). A new home visit was proceeded for an interview with the mothers of a sample of adolescents (the same who had been evaluated at 4 years of age), using the Child and Adolescent Behavior CheckList (CBCL). Results: the prevalence of mental disorder in early adolescence was estimated in 10.8% (95%CI 5.7-15.9). The most prevalent disorders were the group of disruptive behavior disorders, followed by anxiety disorders. By the time CBCL was reapplied after eight years (at the ages of 4 and 12), there was a moderate continuity of psychopathology. Thus, 31% of the children with deviant behavior at 4 years of age kept their deviant scores at 12 years of age. The externalizing problems at 4 years of age were the ones with higher stability and, also, the main predictors of different outcomes in mental health at early adolescence. The factors (measured at birth and fourth year) which remained associated to the problems of attentional and hyperactivity at 12 years of age were: a) family income; b) male sex; c) maternal smoking during pregnancy; d) maternal psychiatric disorder; e) behavioral and emotional problems of the child. Conclusions: our findings were similar to those found in both Brazilian and international studies regarding the prevalence rate, the most frequent psychopathological pattern, the evolution, behavioral antecedents and risk factors of a mental disorder, indicating the universality of mental disorders among different cultures. Environmental, biological and psychological factors, which are present in the beginning of life, had a long-term effect in attention and hyperactivity problems at the adolescence, confirming previous findings in studies of birth cohort.

Made available in DSpace on 2016-04-29T14:18:03Z (GMT). No. of bitstreams: 1 Marcelo Moreira Neumann.pdf: 820859 bytes, checksum: 0d1fd2f4ed0b597fec520874d5a244f7 (MD5) Previous issue date: 2010-05-28 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The disappearance of people, especially children and adolescents awakens a lot of commotion in the society, however scientific studies on the subject are still rare. These few studies do not provide a deep reflection of the conceptual point of view. There is the 'disappearance' is reduced by the relation of cause and effect. The objective of this study was to expand the concept by the visions of sociology, law, psychology and literature, then treat it in its etymological sense. It was found that the origin of the word existing social elements that constitute it, the loss can only occur in human social relationships - in which it is perceived, seen and felt. After delineating the conceptual effort to relate the disappearance of their multiple determinations, highlighting the social causes, natural and psychological. In the social determinations were discussed the historical, cultural, religious, social issues, violence and the influence of totalitarian regimes in the disappearance of people. In natural determinations were shown how people disappear because of natural forces and human action. Discussed the formation of the individual and subjectivity and how these may influence psychological determinations in cases escape of the home or institution. The proposed investigation of the disappearance of children and adolescents from these multiple measurements, with the predominance of social determinations. The following is characterized by participation of those involved in these disappearances, based in some cases assisted by the ´Projeto Caminho de Volta´ - FMUSP. The data obtained from medical records were analyzed and categorized, which resulted in ' table expected behaviors' those involved in the situation of disappearance. These tables show the actions taken by each of the subjects involved soon after the disappearance of children and adolescents. They reveal the kind of relationship - the difficulties and pains of those seeking the missing, as well as the likely reasons for this. In the last chapter were discussed current challenges and perspectives of the topic, related to Brazilian public policy, moving tentatively in consolidating the legal framework for the disappearance in the country. Concluded that when considering the disappearance as a predominantly social situation, removes the load placed by society in missing or their families and forth this universalizing the issue, showing that the problem should be tackled by all / O desaparecimento de pessoas, especialmente de crianças e adolescentes desperta muita comoção na sociedade, entretanto os estudos científicos sobre o tema ainda são raros. Estas poucas publicações existentes não oferecem uma reflexão profunda do ponto de vista conceitual. Nelas o desaparecimento é reduzido pela relação de causa e efeito. O objetivo deste trabalho foi ampliar o conceito pelas visões da sociologia, do direito, da psicologia e da literatura, para posteriormente tratá-lo no seu sentido etimológico. Foi verificado que na origem da palavra já existem os elementos sociais que o constitui, pois, o desaparecimento só pode ocorrer nas relações sociais humanas na qual ele é percebido, observado e sentido. Após a delimitação conceitual procurou-se relacionar o desaparecimento com suas múltiplas determinações, destacando as determinações sociais, naturais e psicológicas. Nas determinações sociais foram debatidos os aspectos históricos, cultural-religiosos, a questão social, as violências e a influência dos regimes totalitários no desaparecimento de pessoas. Nas determinações naturais foram mostradas como as pessoas desaparecem em virtude das forças da natureza e da ação do homem. Discutiu a formação do individuo e de sua subjetividade e, como essas determinações psicológicas podem influenciar nos casos de fugas do lar ou de instituições. A proposta de investigação do desaparecimento de crianças e adolescentes partiu destas múltiplas determinações, com a predominância das determinações sociais. A seguir foi caracterizada a participação dos envolvidos nestes desaparecimentos, fundamentado em alguns casos atendidos pelo Projeto Caminho de Volta - FMUSP. Os dados obtidos nos prontuários foram analisados e categorizados, que resultou em quadros de comportamentos previstos dos envolvidos na situação de desaparecimento. Estes quadros mostram as atitudes tomadas por cada um dos sujeitos envolvidos logo após o desaparecimento de crianças e adolescentes. Eles revelam o tipo de relação - as dificuldades e as dores das pessoas que procuram o desaparecido, como também os prováveis motivadores desta situação. No último capítulo foram debatidos os desafios e perspectivas atuais do tema, relacionados com a política pública brasileira, que se move timidamente na consolidação do marco legal para o desaparecimento no país. Concluí-se que ao considerar o desaparecimento como uma situação predominantemente social, retira-se a carga depositada pela sociedade nos desaparecidos ou nos seus familiares e diante disto universaliza-se a questão, mostrando que o problema deve ser enfrentado por todos

Mental health conditions, such as internalizing disorders, in children and adolescents have been attributed to higher than expected levels of high school dropouts, juvenile crimes, and suicide. Previous research studies provide limited information on factors influencing treatment success for children and adolescents diagnosed with internalizing disorders. This study utilized a nonequivalent comparison group design gathered from an archived data set from a sample of children and adolescents (N = 215) who participated in an intensive outpatient managed mental health care treatment program. Self-report data were retrieved from previous responses to the Children's Depression Inventory and Revised Children's Manifest Anxiety Scale - Second Edition to explore factors related to treatment effectiveness for children and adolescents with internalizing symptoms. Data were analyzed using a mixed model repeated measures ANOVA to analyze main effects and interactions. This analysis identified if gender, ethnicity, age group, and treatment duration were risk factors related to symptom amelioration or deterioration for children and adolescents diagnosed with internalizing disorders across time. Females with internalizing disorders reported significantly higher levels of depression symptom change than males with internalizing disorders. All other results did not show any statistically significant relationships. Results suggest that therapists should consider gender-related factors when providing treatment to children and adolescents with internalizing disorders. Active clinical research epitomizes the belief of social change by putting research to practice and utilizing available tools to predict predictive risk in the treatment of children and adolescents.

ObjectifsL’objectif principal a été de déterminer la quantité d’activité physique chez des enfants de 8- 16 ans,scolarisés dans la ville de Bogota (Colombie) vivant à l’altitude de 2640 mètres. Cette activité, mesurée pendant les périodes scolaires et de vacances et agrégée sur une année, a été exprimée en dépensed’énergie rapportée à la journée (DEJmA, kJ.kg-1.jour-1). Cette activité DEJmA a été secondairementanalysée en fonction de l’âge, du genre, du niveau Socioéconomique (NSE), des donnéesanthropométriques individuelles incluant l’âge biologique (Tanner), la composition corporelle, lesomatotype et la condition physique (EUROFIT).MéthodesCette étude d’épidémiologie descriptive et analytique a comporté cinq phases successives : 1)Elaboration d’un questionnaire QAPACE et formation des chercheurs; 2) Test de compréhension duquestionnaire QAPACE; 3) Etude de faisabilité et reproductibilité de QAPACE; 4) Etude de validationsur un échantillon (36 sujets) des mesures de DEJ par rapport à la mesure de VO2max, selon deuxméthodes directe (cycle d’ergospirométrie) et indirecte (test de Léger); 5) Analyse générale d’unéchantillon représentatif de 1840 enfants selon un sondage en grappe randomisé à deux niveaux (écoles,classes). Le questionnaire étudiait 13 grandes catégories d’activités.Les analyses des données de reproductibilité et de validation ont reposé la méthode de Bland et Altmanet la mesure du CCI. La dépendance de la DEJ en fonction des données socio- économiques et desdonnées anthropométriques a été étudiée avec des méthodes de régression linéaire uni- et multivariée(SPSS 21).RésultatsLe questionnaire, adapté à la population d’enfants de langue hispaniauem a présenté une corrélationintra classe CCI=0.96 (CI 0.95-0.97). La validité avec la mesure de VO2max (direct et indirect) a été de0.76(0.66) (p<0.01). La DEJ moyenne sur les 1840 enfants étaient, chez les 904 garçons, 167.98±37.30kJ.kg-1.jour-1 (valeur absolue : 6.83 MJ/Jour, relative : 170.41±39.92) et, chez les 936 filles165.64±34.26 kJ/kg/jour (p<0.01) (6.59 MJ/jour, 165.64 ±34.26 kJ/kg/j). La DEJ pour la périodescolaire et de vacances fut 158.43±42.99 et 199.44±18.55 kJ/kg/jour (p<0.01) pour les garçons et lesfilles respectivement. La DEJ durant le temps libre fut de 59.86±44.16 chez les garçons et 53.81±37.11kJ/kg/jour (p<0.01) pour les filles.ConclusionsSur la base d’une bonne reproductibilité et validité du questionnaire QAPACE, la DEJ (kJ.kg-1.jour-1)rapporté au poids corporel total ou au poids maigre a donné des résultats inférieurs à ceux d’autresétudes, avec notamment 51% des garçons et 61% de filles inactifs, respectivement. Les garçons furentplus actifs que les filles dans le groupe post pubères (p<0.01). Le temps consacré à regarder la TV étaitde 4.2 heures/jour. Les sports les plus pratiqués étaient le football, le cyclisme, et la marche pour lesgarçons et la marche, le cyclisme et le patinage pour les filles. / ObjectivesThe first statement was to determine the amount of physical activity expressed in expenditure weightedaverage day of a year (DEEmY) energy during the school year and holidays (kJ.kg-1.day-1) in terms ofequivalence caloric and metabolic cost of activities most commonly performed by young people. Thesecond statement was that of defining the relationship between the DEEmY vs age, gender,socioeconomic level (SEL), height, body weight, body surface (BS), the Body Mass Index (BMI),biological age (Tanner), body composition, somatotype and fitness (EUROFIT).MethodsThis descriptive study developed five different phases: the first phase: it was the training of researchers,the second phase: understanding and final questionnaire editing QAPACE, in the third phase: feasibilityand reproducibility of QAPACE in the fourth stage: it was the validation study by direct VO2max (36subjects) by ergospirometry and indirect through the test Leger and the fifth phase cycle was developedin 1840 with the general study subjects. The questionnaire was developed by 13 categories. Forreproducibility and validation of the test-Retest method and comparison of arithmetic by the method ofBland-Altman, Pearson correlation was applied. The data is stored in Visual Fox Pro 6.0 and analyzedusing SPSS 21 statistical program IBM. Means were compared using multivariate linear model applyingtipe II.The values used as fixed variables: gender (male and female), age (8-16 years) and three SEL (six strata:1-2, 3-4 and 5-6); as dependent variables were evaluated: height, weight, leisure time, expressed inhours/day and daily energy expenditure DEE (Kj.kg-1.day-1) during leisure time (DEE-LT) during thetime school (DEE-ST) during the holidays (DEE-VT), and DEE total mean year (DEEmTY).For a post-Hoc analysis was used the minimum significant difference (MSD) with fixed factors,interaction factors descriptive statistics, tests of homogeneity with a significance level of 0.05.ResultsThe questionnaire was correct understanding of the reproducibility intra-Class correlation was r = 0.96(CI 0.95-0.97), the validity of the direct and indirect VO2 was 0.76 (0.66) (p <0.01) and for generalstudy quantifying the average of the DEE of 1840 subjects was 167.98 ± 37.30; for boys (n = 904),absolute value: 6.83 MJ/day, relative: 170.41 ± 39.92 and for girls (n = 936): 6.59 MJ/day (p <0.001)165.64 ± 34.26 (kJ.kg-1.day-1) (p <0.01). The DEE to the school holiday period and was 158.43 ± 42.99and 199.44 ± 18.55 (kJ.kg-1.day-1) (p <0.01) for boys and girls respectively. The DEE during free timewas of 59.86 ± 44.16 for males and 53.81 ± 37.11 (kJ.kg-1.day-1) (p <0.01) for girlsConclusionsOn the basis of good reproducibility and validity of the questionnaire QAPACE applied to students inthe larger study, the DEE (kJ/kg/day) with total body weight or lean weight was less compared to ofother studies giving results for 51% of boys and 61% of inactive girls. Boys were more active than girlsin the post pubertal group (p <0.01). As for the time spent watching TV, it was 4.2 hours/day, and themost popular sports was soccer, cycling, and walking for boys and walking, cycling and skating for

<p><p>Objective:</p><p>This study aimed to investigate the correlation between physical activity level (PAL), measured with activity diary and accelerometer, among overweight and obese children and adolescents. The aim was also to study differences in PAL between girls and boys.</p><p>Design:</p><p>55 children and adolescents, whom been subjected to a physical activity registration with a physical activity diary and accelerometer during three or four days, were included in this study. From the data received from the children’s journal records PAL was calculated and compiled for statistic analysis.</p><p>Results:</p><p>The results of the study showed that the children underestimated their physical activity level when measured with activity diary, in comparison with the physical activity level measured with accelerometer. Differences between girl and boys PAL values were not statistically significant, although the girls PAL values from the accelerometer, but not from the activity diary, reached a moderate activity level according to Nordic nutrition recommendation. No correlation between the activity diary and accelerometer was found.</p><p>Conclusions:</p><p>The Activity diary can not be used as solitary instrument to mesure physical activity in obese or overweight children.</p><p>There is no validated way to measure physical activity in overweight or obese children.</p><p>Before studies can be conducted with reliable results, physical activity level scales and calculated BMR must be designed for overweight and obese children.</p></p>

<p>This study is located within the theoretical framework of construct validation theory. Data for this Secondary Data Analysis study was drawn from the &ldquo / Impact of Hope and Exposure to Community Violence on children&rsquo / s perception of Well-being&rdquo / study. The primary study employed stratified interval criterion sampling to select 565 grade 9 learners, aged 14-18 from six public schools. The dataset for the current study comprised all participants (N=565) of the broader study. As the initial step in validation of the KIDSCREEN-52 within South Africa, the current study examined the factor structure of the KIDSCREEN-52 within this context by means of exploratory factor analysis using principal component analysis with oblimin rotations. It also assessed the internal consistency reliability of each of the scales using Cronbach&rsquo / s alpha. Exploratory factor analysis revealed the same 10 factors as identified by previous European studies with some deviation in the last two factors, which warrants further examination. Internal consistency of the measure was shown to be acceptable, with Cronbach&rsquo / s alpha values ranging from 0.76 to 0.81 for the 10 scales.</p>

Background: The consideration of impairment plays a crucial role in detecting significant mental health problems in children whose symptoms do not meet diagnostic criteria. The assessment of impairment may be particularly relevant when only short screening instruments are applied in epidemiological surveys. Furthermore, differences between childrens’ and parents’ perceptions of present impairment and impairing symptoms are of interest with respect to treatment-seeking behaviour. Objectives: The objectives were to assess parent- and self-reported impairment due to mental health problems in a representative sample of children and adolescents; to describe the characteristics of highly impaired children with normal symptom scores; and to investigate the associations between symptoms in different problem areas and impairment. Methods: The mental health module of the German Health Interview and Examination Survey for Children and Adolescents (the BELLA study) examined mental health in a representative sub-sample of 2,863 families with children aged 7–17. Self-reported and parent-reported symptoms of mental health problems and associated impairment were identified by the extended version of the strengths and difficulties questionnaire (SDQ) in children 11 years and older. Results: Considerable levels of distress and functional impairment were found with 14.1% of the boys and 9.9% of the girls being severely impaired according to the parental reports. However, self-reported data shows a reversed gender-difference as well as lower levels of severe impairment (6.1% in boys; 10.0% in girls). Six percent of the sampled children suffer from pronounced impairment due to mental health problems but were not detected by screening for overall symptoms. Childrens’ and parents’ reports differed in regard to the association between reported symptom scores and associated impairment with children reporting higher impairment due to emotional problems. Conclusions: The assessment of impairment caused by mental health problems provides important information beyond the knowledge of symptoms and helps to identify an otherwise undetected high risk group. In the assessment of impairment, gender-specific issues have to be taken into account. Regarding the systematic differences between childrens’ and parents’ reports in the assessment of impairment, the child’s perspective should be given special attention.

Sverige är bland de länder som tar emot flest flyktingar, utav dessa utgör en del ensamkommande barn som vanligtvis varit med om hemska upplevelser och lider av olika hälsoproblem som tar sig både psykiska eller fysiska uttryck. Det är således viktigt att personal som arbetar med denna målgrupp kan förse dem med stöd och kunskap. Studien har undersökt personalens uppfattningar om arbetet på boenden med ensamkommande flyktingbarn är ur ett hälsofrämjande perspektiv. Teorierna KASAM med dess tre delkomponenter: meningsfullhet, begriplighet samt hanterbarhet och socialt stöd ligger som grund. I studien har en kvalitativ ansats tillämpats där fem personal på två boenden blivit intervjuade med en semistrukturerad metod. Resultatet visade att personalens synsätt på hälsofrämjande var olika för alla i personalen men grunderna densamma. Ett hälsofrämjande arbete genomfördes på boendena där personal arbetade med bland annat informationspridning, fysisk aktivitet och delaktighet. Underlättande faktorer på boendet var kommunikationen och det sociala samspelet med ungdomarna samt sina medarbetare. Kommunikationen var även ett hinder eftersom att språkbarriäerna kom emellan eller att tolk inte översatte korrekt. Slutsatserna i studien är att personalens synsätt på hälsofrämjande är lika i grunden, personalens arbetssätt är hälsofrämjande och det finns både underlättande samt försvårande faktorer i det hälsofrämjande arbetet. / Sweden is among the countries that is receiving the most refugees, a part of these are unaccompanied children who usually been through terrible experiences and are suffering from various health problems that is displayed both mentally and physically. It is therefore important that staff working with this target group can provide them with the support and knowledge. This study examined the staff´s perceptions of their work, with unaccompanied refugee children, as being conducted from a from a health promotion perspective. The theories SOC, which has three subcomponents: meaningfulness, comprehensibility and manageability and social support are the foundation. The study has applied a qualitative approach where five staff’s on two accommodation were interviewed using a semi-structured approach. The results showed that the approach of a health promotion perspective was different for all the staff however the basics where the same. Health promotion were conducted on both accommodations where the staff worked among other things with the dissemination of information, physical activity and with participation. Facilitators at the accommodation was communication and social interaction with the young people and the workers. Communication was also a major obstacle since the language barrier came between or the interpreter did not translate correctly. The conclusions of the study is that the staff's approach to health promotion is equal fundamentally, the staff's approach are health promoting and there are both facilitating and aggravating factors in the health promotion work.

Objective: This study aimed to investigate the correlation between physical activity level (PAL), measured with activity diary and accelerometer, among overweight and obese children and adolescents. The aim was also to study differences in PAL between girls and boys. Design: 55 children and adolescents, whom been subjected to a physical activity registration with a physical activity diary and accelerometer during three or four days, were included in this study. From the data received from the children’s journal records PAL was calculated and compiled for statistic analysis. Results: The results of the study showed that the children underestimated their physical activity level when measured with activity diary, in comparison with the physical activity level measured with accelerometer. Differences between girl and boys PAL values were not statistically significant, although the girls PAL values from the accelerometer, but not from the activity diary, reached a moderate activity level according to Nordic nutrition recommendation. No correlation between the activity diary and accelerometer was found. Conclusions: The Activity diary can not be used as solitary instrument to mesure physical activity in obese or overweight children. There is no validated way to measure physical activity in overweight or obese children. Before studies can be conducted with reliable results, physical activity level scales and calculated BMR must be designed for overweight and obese children.